{"title":"Correction to: Handle with care: challenges associated with ultra-processed foods research.","authors":"","doi":"10.1093/ije/dyae133","DOIUrl":"https://doi.org/10.1093/ije/dyae133","url":null,"abstract":"","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ruth Young, Joseph Ssekasanvu, Joseph Kagaayi, Robert Ssekubugu, Godfrey Kigozi, Steven J Reynolds, Maria J Wawer, Bareng Aletta Sanny Nonyane, Betty Nantume, Thomas C Quinn, Aaron A R Tobian, John Santelli, Larry W Chang, Caitlin E Kennedy, Ligia Paina, Philip A Anglewicz, David Serwadda, Fred Nalugoda, Mary Kate Grabowski
Background: The impact of migration on HIV risk among non-migrating household members is poorly understood. We measured HIV incidence among non-migrants living in households with and without migrants in Uganda.
Methods: We used four survey rounds of data collected from July 2011 to May 2018 from non-migrant participants aged 15-49 years in the Rakai Community Cohort Study. Non-migrants were individuals with no-migration between surveys or at the prior survey. Household migration was defined as ≥1 household member migrating into or out of the house from another community between surveys (∼18 months). Incident HIV was defined as testing HIV seropositive following a negative result. Incidence rate ratios (IRRs) were estimated using Poisson regression with generalized estimating equations. Analyses were stratified by gender, migration into or out of the household and the relationship between non-migrants and migrants (e.g. spouse, child).
Results: About 11 318 non-migrants (5674 women) were followed for 37 320 person-years. Twenty-eight percent (6059/21 370) of non-migrant person-visits had recent migration into or out of the household, and 240 HIV incident cases were identified. Overall, non-migrants in migrant households were not at greater risk of acquiring HIV than non-migrants in households without any migration. However, men were significantly more likely to acquire HIV if their spouse had recently migrated in [adjusted IRR: 2.12; 95% confidence interval (CI): 1.05-4.27] or out (adjusted IRR: 4.01; 95% CI, 2.16-7.44) compared with men with no spousal migration.
Conclusions: HIV incidence is higher among non-migrant men with migrant spouses. Targeted HIV testing and prevention interventions like pre-exposure prophylaxis could be considered for men with migrant spouses.
{"title":"HIV incidence among non-migrating persons following a household migration event in Uganda.","authors":"Ruth Young, Joseph Ssekasanvu, Joseph Kagaayi, Robert Ssekubugu, Godfrey Kigozi, Steven J Reynolds, Maria J Wawer, Bareng Aletta Sanny Nonyane, Betty Nantume, Thomas C Quinn, Aaron A R Tobian, John Santelli, Larry W Chang, Caitlin E Kennedy, Ligia Paina, Philip A Anglewicz, David Serwadda, Fred Nalugoda, Mary Kate Grabowski","doi":"10.1093/ije/dyae118","DOIUrl":"10.1093/ije/dyae118","url":null,"abstract":"<p><strong>Background: </strong>The impact of migration on HIV risk among non-migrating household members is poorly understood. We measured HIV incidence among non-migrants living in households with and without migrants in Uganda.</p><p><strong>Methods: </strong>We used four survey rounds of data collected from July 2011 to May 2018 from non-migrant participants aged 15-49 years in the Rakai Community Cohort Study. Non-migrants were individuals with no-migration between surveys or at the prior survey. Household migration was defined as ≥1 household member migrating into or out of the house from another community between surveys (∼18 months). Incident HIV was defined as testing HIV seropositive following a negative result. Incidence rate ratios (IRRs) were estimated using Poisson regression with generalized estimating equations. Analyses were stratified by gender, migration into or out of the household and the relationship between non-migrants and migrants (e.g. spouse, child).</p><p><strong>Results: </strong>About 11 318 non-migrants (5674 women) were followed for 37 320 person-years. Twenty-eight percent (6059/21 370) of non-migrant person-visits had recent migration into or out of the household, and 240 HIV incident cases were identified. Overall, non-migrants in migrant households were not at greater risk of acquiring HIV than non-migrants in households without any migration. However, men were significantly more likely to acquire HIV if their spouse had recently migrated in [adjusted IRR: 2.12; 95% confidence interval (CI): 1.05-4.27] or out (adjusted IRR: 4.01; 95% CI, 2.16-7.44) compared with men with no spousal migration.</p><p><strong>Conclusions: </strong>HIV incidence is higher among non-migrant men with migrant spouses. Targeted HIV testing and prevention interventions like pre-exposure prophylaxis could be considered for men with migrant spouses.</p>","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pedro C Hallal, I-Min Lee, Olga Lucia Sarmiento, Kenneth E Powell
{"title":"The future of physical activity: from sick individuals to healthy populations.","authors":"Pedro C Hallal, I-Min Lee, Olga Lucia Sarmiento, Kenneth E Powell","doi":"10.1093/ije/dyae129","DOIUrl":"https://doi.org/10.1093/ije/dyae129","url":null,"abstract":"","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11427673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142336407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andri Iona, Fiona Bragg, Zammy Fairhurst-Hunter, Iona Y Millwood, Neil Wright, Kuang Lin, Ling Yang, Huaidong Du, Yiping Chen, Pei Pei, Liang Cheng, Dan Schmidt, Daniel Avery, Canqing Yu, Jun Lv, Robert Clarke, Robin Walters, Liming Li, Sarah Parish, Zhengming Chen
Background: Higher body mass index (BMI) is associated with higher incidence of cardiovascular and some non-cardiovascular diseases (CVDs/non-CVDs). However, uncertainty remains about its associations with mortality, particularly at lower BMI levels.
Methods: The prospective China Kadoorie Biobank recruited >512 000 adults aged 30-79 years in 2004-08 and genotyped a random subset of 76 000 participants. In conventional and Mendelian randomization (MR) analyses, Cox regression yielded adjusted hazard ratios (HRs) associating measured and genetically predicted BMI levels with incident risks of major vascular events (MVEs; conventional/MR 68 431/23 621), ischaemic heart disease (IHD; 50 698/12 177), ischaemic stroke (IS; 42 427/11 897) and intracerebral haemorrhage (ICH; 7644/4712), and with mortality risks of CVD (15 427/6781), non-CVD (26 915/4355) and all causes (42 342/6784), recorded during ∼12 years of follow-up.
Results: Overall, the mean BMI was 23.8 (standard deviation: 3.2) kg/m2 and 13% had BMIs of <20 kg/m2. Measured and genetically predicted BMI showed positive log-linear associations with MVE, IHD and IS, but a shallower positive association with ICH in conventional analyses. Adjusted HRs per 5 kg/m2 higher genetically predicted BMI were 1.50 (95% CI 1.41-1.58), 1.49 (1.38-1.61), 1.42 (1.31-1.54) and 1.64 (1.58-1.69) for MVE, IHD, IS and ICH, respectively. These were stronger than associations in conventional analyses [1.21 (1.20-1.23), 1.28 (1.26-1.29), 1.31 (1.29-1.33) and 1.14 (1.10-1.18), respectively]. At BMIs of ≥20 kg/m2, there were stronger positive log-linear associations of BMI with CVD, non-CVD and all-cause mortality in MR than in conventional analyses.
Conclusions: Among relatively lean Chinese adults, higher genetically predicted BMI was associated with higher risks of incident CVDs. Excess mortality risks at lower BMI in conventional analyses are likely not causal and may reflect residual reverse causality.
{"title":"Conventional and genetic associations of BMI with major vascular and non-vascular disease incidence and mortality in a relatively lean Chinese population: U-shaped relationship revisited.","authors":"Andri Iona, Fiona Bragg, Zammy Fairhurst-Hunter, Iona Y Millwood, Neil Wright, Kuang Lin, Ling Yang, Huaidong Du, Yiping Chen, Pei Pei, Liang Cheng, Dan Schmidt, Daniel Avery, Canqing Yu, Jun Lv, Robert Clarke, Robin Walters, Liming Li, Sarah Parish, Zhengming Chen","doi":"10.1093/ije/dyae125","DOIUrl":"https://doi.org/10.1093/ije/dyae125","url":null,"abstract":"<p><strong>Background: </strong>Higher body mass index (BMI) is associated with higher incidence of cardiovascular and some non-cardiovascular diseases (CVDs/non-CVDs). However, uncertainty remains about its associations with mortality, particularly at lower BMI levels.</p><p><strong>Methods: </strong>The prospective China Kadoorie Biobank recruited >512 000 adults aged 30-79 years in 2004-08 and genotyped a random subset of 76 000 participants. In conventional and Mendelian randomization (MR) analyses, Cox regression yielded adjusted hazard ratios (HRs) associating measured and genetically predicted BMI levels with incident risks of major vascular events (MVEs; conventional/MR 68 431/23 621), ischaemic heart disease (IHD; 50 698/12 177), ischaemic stroke (IS; 42 427/11 897) and intracerebral haemorrhage (ICH; 7644/4712), and with mortality risks of CVD (15 427/6781), non-CVD (26 915/4355) and all causes (42 342/6784), recorded during ∼12 years of follow-up.</p><p><strong>Results: </strong>Overall, the mean BMI was 23.8 (standard deviation: 3.2) kg/m2 and 13% had BMIs of <20 kg/m2. Measured and genetically predicted BMI showed positive log-linear associations with MVE, IHD and IS, but a shallower positive association with ICH in conventional analyses. Adjusted HRs per 5 kg/m2 higher genetically predicted BMI were 1.50 (95% CI 1.41-1.58), 1.49 (1.38-1.61), 1.42 (1.31-1.54) and 1.64 (1.58-1.69) for MVE, IHD, IS and ICH, respectively. These were stronger than associations in conventional analyses [1.21 (1.20-1.23), 1.28 (1.26-1.29), 1.31 (1.29-1.33) and 1.14 (1.10-1.18), respectively]. At BMIs of ≥20 kg/m2, there were stronger positive log-linear associations of BMI with CVD, non-CVD and all-cause mortality in MR than in conventional analyses.</p><p><strong>Conclusions: </strong>Among relatively lean Chinese adults, higher genetically predicted BMI was associated with higher risks of incident CVDs. Excess mortality risks at lower BMI in conventional analyses are likely not causal and may reflect residual reverse causality.</p>","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142390442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Won Jin Lee, Jaeho Jeong, Ye Jin Bang, Young Min Kim
Background: The healthy worker effect may distort the association between exposure and health effects in workers. However, few studies have investigated both the healthy worker hire and survival effects simultaneously, and they are limited to mortality studies in male workers.
Methods: We utilized a data set comprising South Korean diagnostic medical radiation workers registered in the National Dose Registry between 1996 and 2011, and merged it with mortality and cancer incidence data. Standardized mortality ratios (SMRs) and standardized incidence ratios (SIRs) were computed for comparison with the general population. To account for time-varying confounders influenced by prior occupational radiation exposure, we applied g-estimation using structural nested accelerated failure time models and compared the outcomes with those from Weibull regression.
Results: A total of 1831 deaths and 3759 first primary cancer cases were identified among 93 918 workers. Both male (SMR = 0.44; 95% CI: 0.42, 0.46) and female workers (SMR = 0.53; 95% CI: 0.46, 0.60) showed lower mortality rates compared with national rates. In the SIR analysis, male workers exhibited reduced risks of solid cancer whereas female workers had increased risks. The g-estimation-derived hazard ratios (HRs) from radiation exposure exceeded those from Weibull regression estimates for all-cause death (HR = 2.55; 95% CI: 1.97, 3.23) and all-cancer incidence (HR = 1.96; 95% CI: 1.52, 2.55) in male workers whereas female workers showed the opposite results.
Conclusions: Comprehensive consideration of the healthy worker effect by sex is essential for estimating the unbiased impact of occupational exposure on health outcomes, notably in studies focusing on male mortality.
{"title":"Healthy worker hire and survivor effects in a cohort of medical radiation workers.","authors":"Won Jin Lee, Jaeho Jeong, Ye Jin Bang, Young Min Kim","doi":"10.1093/ije/dyae130","DOIUrl":"10.1093/ije/dyae130","url":null,"abstract":"<p><strong>Background: </strong>The healthy worker effect may distort the association between exposure and health effects in workers. However, few studies have investigated both the healthy worker hire and survival effects simultaneously, and they are limited to mortality studies in male workers.</p><p><strong>Methods: </strong>We utilized a data set comprising South Korean diagnostic medical radiation workers registered in the National Dose Registry between 1996 and 2011, and merged it with mortality and cancer incidence data. Standardized mortality ratios (SMRs) and standardized incidence ratios (SIRs) were computed for comparison with the general population. To account for time-varying confounders influenced by prior occupational radiation exposure, we applied g-estimation using structural nested accelerated failure time models and compared the outcomes with those from Weibull regression.</p><p><strong>Results: </strong>A total of 1831 deaths and 3759 first primary cancer cases were identified among 93 918 workers. Both male (SMR = 0.44; 95% CI: 0.42, 0.46) and female workers (SMR = 0.53; 95% CI: 0.46, 0.60) showed lower mortality rates compared with national rates. In the SIR analysis, male workers exhibited reduced risks of solid cancer whereas female workers had increased risks. The g-estimation-derived hazard ratios (HRs) from radiation exposure exceeded those from Weibull regression estimates for all-cause death (HR = 2.55; 95% CI: 1.97, 3.23) and all-cancer incidence (HR = 1.96; 95% CI: 1.52, 2.55) in male workers whereas female workers showed the opposite results.</p><p><strong>Conclusions: </strong>Comprehensive consideration of the healthy worker effect by sex is essential for estimating the unbiased impact of occupational exposure on health outcomes, notably in studies focusing on male mortality.</p>","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11452196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chengzhe Tao, Zhi Li, Yun Fan, Yuna Huang, Tingya Wan, Mingxue Shu, Shuwen Han, Hong Qian, Wenkai Yan, Qiaoqiao Xu, Yankai Xia, Chuncheng Lu, You Li
Background: This study aimed to estimate population-level and state-level lead-attributable mortality burdens stratified by socioeconomic status (SES) class in the USA.
Methods: Based on the National Health and Nutrition Examination Survey (NHANES), we constructed individual-level SES scores from income, employment, education and insurance data. We assessed the association between the blood lead levels (BLL) and all-cause mortality by Cox regression in the NHANES cohort (n = 31 311, 4467 deaths). With estimated hazard ratios (HR) and prevalences of medium (2-5 μg/dL) and high (≥ 5 μg/dL) BLL, we computed SES-stratified population-attributable fractions (PAFs) of all-cause mortality from lead exposure across 1999-2019. We additionally conducted a systematic review to estimate the lead-attributable mortality burden at state-level.
Results: The HR for every 2-fold increase in the BLL decreased from 1.23 (1.10-1.38) for the lowest SES class to 1.05 (0.90-1.23) for the highest SES class. Across all SES quintiles, medium BLL exhibited a greater mortality burden. Individuals with lower SES had higher lead-attributable burdens, and such disparities haver persisted over the past two decades. In 2017-19, annually 67 000 (32 000-112 000) deaths in the USA were attributable to lead exposure, with 18 000 (2000-41 000) of these deaths occurring in the lowest SES class. Substantial disparities in the state-level mortality burden attributable to lead exposure were also highlighted.
Conclusions: These findings suggested that disparities in lead-attributable mortality burden persisted within US adults, due to heterogeneities in the effect sizes of lead exposure as well as in the BLL among different SES classes.
背景:本研究旨在估算美国按社会经济地位(SES)分层的人口和州级铅致死负担:本研究旨在估算美国按社会经济地位(SES)分层的人口级和州级铅致死负担:方法:根据美国国家健康与营养调查(NHANES),我们从收入、就业、教育和保险数据中构建了个人层面的 SES 分数。我们通过 Cox 回归评估了 NHANES 队列(n = 31 311,4467 例死亡)中血铅水平(BLL)与全因死亡率之间的关系。根据估计的危险比(HR)以及中(2-5 μg/dL)和高(≥ 5 μg/dL)BLL 的流行率,我们计算了 1999-2019 年间铅暴露导致的全因死亡率的 SES 分层人群可归因分数(PAF)。此外,我们还进行了一项系统性回顾,以估算州一级的可归因于铅的死亡率负担:铅含量每增加 2 倍的 HR 值从最低 SES 等级的 1.23(1.10-1.38)降至最高 SES 等级的 1.05(0.90-1.23)。在所有五等分社会经济地位人群中,中等生活质量铅含量人群的死亡率较高。社会经济地位较低的人的铅可归因负担较高,这种差异在过去二十年中一直存在。2017-19年,美国每年有67 000例(32 000-112 000)死亡可归因于铅暴露,其中18 000例(2000-41 000)发生在社会经济地位最低的阶层。此外,各州因接触铅而导致的死亡率也存在巨大差异:这些研究结果表明,在美国成年人中,由于铅暴露的效应大小以及不同社会经济地位阶层的铅含量(BLL)存在差异,铅导致的死亡负担的差异依然存在。
{"title":"Estimating lead-attributable mortality burden by socioeconomic status in the USA.","authors":"Chengzhe Tao, Zhi Li, Yun Fan, Yuna Huang, Tingya Wan, Mingxue Shu, Shuwen Han, Hong Qian, Wenkai Yan, Qiaoqiao Xu, Yankai Xia, Chuncheng Lu, You Li","doi":"10.1093/ije/dyae089","DOIUrl":"https://doi.org/10.1093/ije/dyae089","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to estimate population-level and state-level lead-attributable mortality burdens stratified by socioeconomic status (SES) class in the USA.</p><p><strong>Methods: </strong>Based on the National Health and Nutrition Examination Survey (NHANES), we constructed individual-level SES scores from income, employment, education and insurance data. We assessed the association between the blood lead levels (BLL) and all-cause mortality by Cox regression in the NHANES cohort (n = 31 311, 4467 deaths). With estimated hazard ratios (HR) and prevalences of medium (2-5 μg/dL) and high (≥ 5 μg/dL) BLL, we computed SES-stratified population-attributable fractions (PAFs) of all-cause mortality from lead exposure across 1999-2019. We additionally conducted a systematic review to estimate the lead-attributable mortality burden at state-level.</p><p><strong>Results: </strong>The HR for every 2-fold increase in the BLL decreased from 1.23 (1.10-1.38) for the lowest SES class to 1.05 (0.90-1.23) for the highest SES class. Across all SES quintiles, medium BLL exhibited a greater mortality burden. Individuals with lower SES had higher lead-attributable burdens, and such disparities haver persisted over the past two decades. In 2017-19, annually 67 000 (32 000-112 000) deaths in the USA were attributable to lead exposure, with 18 000 (2000-41 000) of these deaths occurring in the lowest SES class. Substantial disparities in the state-level mortality burden attributable to lead exposure were also highlighted.</p><p><strong>Conclusions: </strong>These findings suggested that disparities in lead-attributable mortality burden persisted within US adults, due to heterogeneities in the effect sizes of lead exposure as well as in the BLL among different SES classes.</p>","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gitte Lindved Petersen, Terese Sara Høj Jørgensen, Jimmi Mathisen, Merete Osler, Erik Lykke Mortensen, Drude Molbo, Charlotte Ørsted Hougaard, Theis Lange, Rikke Lund
Background: Empirical evaluation of inverse probability weighting (IPW) for self-selection bias correction is inaccessible without the full source population. We aimed to: (i) investigate how self-selection biases frequency and association measures and (ii) assess self-selection bias correction using IPW in a cohort with register linkage.
Methods: The source population included 17 936 individuals invited to the Copenhagen Aging and Midlife Biobank during 2009-11 (ages 49-63 years). Participants counted 7185 (40.1%). Register data were obtained for every invited person from 7 years before invitation to the end of 2020. The association between education and mortality was estimated using Cox regression models among participants, IPW participants and the source population.
Results: Participants had higher socioeconomic position and fewer hospital contacts before baseline than the source population. Frequency measures of participants approached those of the source population after IPW. Compared with primary/lower secondary education, upper secondary, short tertiary, bachelor and master/doctoral were associated with reduced risk of death among participants (adjusted hazard ratio [95% CI]: 0.60 [0.46; 0.77], 0.68 [0.42; 1.11], 0.37 [0.25; 0.54], 0.28 [0.18; 0.46], respectively). IPW changed the estimates marginally (0.59 [0.45; 0.77], 0.57 [0.34; 0.93], 0.34 [0.23; 0.50], 0.24 [0.15; 0.39]) but not only towards those of the source population (0.57 [0.51; 0.64], 0.43 [0.32; 0.60], 0.38 [0.32; 0.47], 0.22 [0.16; 0.29]).
Conclusions: Frequency measures of study participants may not reflect the source population in the presence of self-selection, but the impact on association measures can be limited. IPW may be useful for (self-)selection bias correction, but the returned results can still reflect residual or other biases and random errors.
{"title":"Inverse probability weighting for self-selection bias correction in the investigation of social inequality in mortality.","authors":"Gitte Lindved Petersen, Terese Sara Høj Jørgensen, Jimmi Mathisen, Merete Osler, Erik Lykke Mortensen, Drude Molbo, Charlotte Ørsted Hougaard, Theis Lange, Rikke Lund","doi":"10.1093/ije/dyae097","DOIUrl":"https://doi.org/10.1093/ije/dyae097","url":null,"abstract":"<p><strong>Background: </strong>Empirical evaluation of inverse probability weighting (IPW) for self-selection bias correction is inaccessible without the full source population. We aimed to: (i) investigate how self-selection biases frequency and association measures and (ii) assess self-selection bias correction using IPW in a cohort with register linkage.</p><p><strong>Methods: </strong>The source population included 17 936 individuals invited to the Copenhagen Aging and Midlife Biobank during 2009-11 (ages 49-63 years). Participants counted 7185 (40.1%). Register data were obtained for every invited person from 7 years before invitation to the end of 2020. The association between education and mortality was estimated using Cox regression models among participants, IPW participants and the source population.</p><p><strong>Results: </strong>Participants had higher socioeconomic position and fewer hospital contacts before baseline than the source population. Frequency measures of participants approached those of the source population after IPW. Compared with primary/lower secondary education, upper secondary, short tertiary, bachelor and master/doctoral were associated with reduced risk of death among participants (adjusted hazard ratio [95% CI]: 0.60 [0.46; 0.77], 0.68 [0.42; 1.11], 0.37 [0.25; 0.54], 0.28 [0.18; 0.46], respectively). IPW changed the estimates marginally (0.59 [0.45; 0.77], 0.57 [0.34; 0.93], 0.34 [0.23; 0.50], 0.24 [0.15; 0.39]) but not only towards those of the source population (0.57 [0.51; 0.64], 0.43 [0.32; 0.60], 0.38 [0.32; 0.47], 0.22 [0.16; 0.29]).</p><p><strong>Conclusions: </strong>Frequency measures of study participants may not reflect the source population in the presence of self-selection, but the impact on association measures can be limited. IPW may be useful for (self-)selection bias correction, but the returned results can still reflect residual or other biases and random errors.</p>","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141599270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carren Ginsburg, Mark A Collinson, Chantel F Pheiffer, F Xavier Gómez-Olivé, Sadson Harawa, Stephen T McGarvey, Daniel Ohene-Kwofie, Andrew D Foster, Tyler W Myroniuk, Mark N Lurie, Stephen M Tollman, Michael J White
{"title":"Cohort Profile: Migrant Health Follow-Up Study (MHFUS) of internal migration in South Africa.","authors":"Carren Ginsburg, Mark A Collinson, Chantel F Pheiffer, F Xavier Gómez-Olivé, Sadson Harawa, Stephen T McGarvey, Daniel Ohene-Kwofie, Andrew D Foster, Tyler W Myroniuk, Mark N Lurie, Stephen M Tollman, Michael J White","doi":"10.1093/ije/dyae081","DOIUrl":"10.1093/ije/dyae081","url":null,"abstract":"","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11168786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141310674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bikram Karmakar, Ann G Zauber, Anne I Hahn, Yan Kwan Lau, Chyke A Doubeni, Marshall M Joffe
Background: Observational studies are frequently used to estimate the comparative effectiveness of different colorectal cancer (CRC) screening methods due to the practical limitations and time needed to conduct large clinical trials. However, time-varying confounders, e.g. polyp detection in the last screening, can bias statistical results. Recently, generalized methods, or G-methods, have been used for the analysis of observational studies of CRC screening, given their ability to account for such time-varying confounders. Discretization, or the process of converting continuous functions into discrete counterparts, is required for G-methods when the treatment and outcomes are assessed at a continuous scale.
Development: This paper evaluates the interplay between time-varying confounding and discretization, which can induce bias in assessing screening effectiveness. We investigate this bias in evaluating the effect of different CRC screening methods that differ from each other in typical screening frequency.
Application: First, using theory, we establish the direction of the bias. Then, we use simulations of hypothetical settings to study the bias magnitude for varying levels of discretization, frequency of screening and length of the study period. We develop a method to assess possible bias due to coarsening in simulated situations.
Conclusions: The proposed method can inform future studies of screening effectiveness, especially for CRC, by determining the choice of interval lengths where data are discretized to minimize bias due to coarsening while balancing computational costs.
背景:由于开展大型临床试验的实际限制和所需时间,观察性研究常用于估算不同结直肠癌(CRC)筛查方法的比较效果。然而,时变混杂因素(如上次筛查中的息肉检测)会使统计结果产生偏差。最近,由于广义方法(或称 G 方法)能够考虑此类时变混杂因素,因此被用于分析 CRC 筛查的观察性研究。当治疗和结果以连续尺度进行评估时,G 方法需要进行离散化处理,即把连续函数转换为离散对应函数的过程:本文对时变混杂因素和离散化之间的相互作用进行了评估,时变混杂因素和离散化可能会在评估筛查效果时产生偏差。我们在评估不同 CRC 筛查方法的效果时研究了这种偏差,这些方法的典型筛查频率各不相同:应用:首先,我们利用理论确定了偏差的方向。然后,我们通过模拟假设环境,研究不同离散程度、筛查频率和研究期长度下的偏差大小。我们开发了一种方法来评估模拟情况下由于粗化而可能产生的偏差:结论:所提出的方法可为今后的筛查有效性研究(尤其是针对 CRC 的筛查有效性研究)提供参考,方法是确定选择数据离散化的时间间隔长度,以便在平衡计算成本的同时最大限度地减少粗粒化导致的偏差。
{"title":"Bias due to coarsening of time intervals in the inference for the effectiveness of colorectal cancer screening.","authors":"Bikram Karmakar, Ann G Zauber, Anne I Hahn, Yan Kwan Lau, Chyke A Doubeni, Marshall M Joffe","doi":"10.1093/ije/dyae096","DOIUrl":"10.1093/ije/dyae096","url":null,"abstract":"<p><strong>Background: </strong>Observational studies are frequently used to estimate the comparative effectiveness of different colorectal cancer (CRC) screening methods due to the practical limitations and time needed to conduct large clinical trials. However, time-varying confounders, e.g. polyp detection in the last screening, can bias statistical results. Recently, generalized methods, or G-methods, have been used for the analysis of observational studies of CRC screening, given their ability to account for such time-varying confounders. Discretization, or the process of converting continuous functions into discrete counterparts, is required for G-methods when the treatment and outcomes are assessed at a continuous scale.</p><p><strong>Development: </strong>This paper evaluates the interplay between time-varying confounding and discretization, which can induce bias in assessing screening effectiveness. We investigate this bias in evaluating the effect of different CRC screening methods that differ from each other in typical screening frequency.</p><p><strong>Application: </strong>First, using theory, we establish the direction of the bias. Then, we use simulations of hypothetical settings to study the bias magnitude for varying levels of discretization, frequency of screening and length of the study period. We develop a method to assess possible bias due to coarsening in simulated situations.</p><p><strong>Conclusions: </strong>The proposed method can inform future studies of screening effectiveness, especially for CRC, by determining the choice of interval lengths where data are discretized to minimize bias due to coarsening while balancing computational costs.</p>","PeriodicalId":14147,"journal":{"name":"International journal of epidemiology","volume":null,"pages":null},"PeriodicalIF":6.4,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11246168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}